Prevention Of Hospital-acquired Infections Research Articles

Incidence and risk factors for hospital-acquired infection among paediatric patients in a teaching hospital: a prospective study in southeast Ethiopia

ObjectivesIn order to maximise the prevention of hospital-acquired infections (HAIs) and antimicrobial resistance, data on the incidence of HAIs are crucial. In Ethiopia, data about the occurrence of HAIs among...

Can patient-reported room cleanliness measures predict hospital-acquired C. difficile infection? A study of acute care facilities in New York state

Patient experience measures, like those form the Hospital Consumer Assessment of Healthcare providers and Systems survey, are increasingly used in healthcare policy decisions. However, it remains unclear if these reflect quality of care, like rates of hospital-acquired infections (HAIs). This study examined the relationship between patient-reported room cleanliness, from the Hospital Consumer Assessment of Healthcare providers and Systems survey, and hospital-acquired C. difficile infection (HA-CDI) rates in NYS acute care hospitals. A random-effects regression analysis compared the percentage of patients indicating their room was "always" and "sometimes/never" kept clean to that facility's average HA-CDI rates, controlling for known predictors. A higher percentage of patients reporting their room was "always" kept clean was associated with significantly lower rates of HA-CDI. Facilities experience 0.031 fewer cases of HA-CDI/1,000 discharges for every percentage point increase in the number of patients rating their room as "always" clean (P = .006). A higher percentage of patients reporting their room was "sometimes/never" kept clean was associated with higher rates of HA-CDI (β = 0.033), but this was not significant (P = .096). These findings suggest patient perceptions of cleanliness may reflect microbial cleanliness and these measures could assist in the prevention of HAIs. However, further research is needed.

STRATEGIES TO HALT 2019 NOVEL CORONAVIRUS (COVID-19) SPREAD FOR ORGAN TRANSPLANTATION PROGRAMS AT THE SICHUAN ACADEMY OF MEDICAL SCIENCE AND SICHUAN PROVINCIAL PEOPLE’S HOSPITAL, CHINA

Originated from Wuhan and expanded throughout China and the world, the 2019 novel coronavirus (COVID-19), has caused worldwide attention. As of March 21, the overall confirmed cases reached to 0.2 million in 172 countries. In all Chinese Medical Centers, elective surgery and the living donor transplantation has been suspended due to the rapid spread of the coronavirus. In contrast, the cadaveric donor transplantations were mostly performed. Therefore, strategies to interrupt transmission within transplantation wards were essential. To date, we have performed at our center ten cases of kidney, four liver and two lung transplants (from deceased organ donors) during the coronavirus outbreak in China (from January 24th to March 11th, 2020). Based on our experience in combating the coronavirus while performing these organ transplants, we comprehensively address here the strategies for the prevention of the virus spread within the transplantation wards. Donor management The potential organ donors were cleared for epidemiology history and should not have traveled from or have contact with people from epidemic areas. Virus nucleic acid from pharyngeal swab specimens was determined, and chest CT was performed. Only when they were confirmed negative for coronavirus, related laboratory tests as HLA typing of donor, antibody detection of the receptor and complement dependent cytotoxicity test could be performed. Recipient management The potential recipients were screened for coronavirus (nucleic acid determination and chest CT scanning) on admission day. Further, additional information was collected from the recipient such as travel history, close contacts, daily body temperature and respiratory symptoms. During the hospitalization period, recipients received COVID-19 related education. Meanwhile, they were given new surgical masks every six hours. We also collaborated with psychologists to provide consultations. Post-transplant immunosuppression was maintained at usual doses. If the recipient had fever, cough, diarrhea or pulmonary infection manifestations, the patient was considered as suspected for contamination and was quarantined within an isolation ward. Accompanying family members of recipients also received COVID-19 related screening as mentioned above. In addition, regular visits were not allowed. Prevention of hospital-acquired infections We implemented strict protocols in preventions of HAIs, including training of HCPs and providing personal protective equipment. Outcome of the organ transplant recipients From January 24th to March 11th, we successfully performed 16 organ transplant operations (10 kidney, 4 liver and 2 lung transplants).

Decreasing Rate of CLABSI in a Long Term Acute Care Hospital

Background During 2016, our Long Term Acute Care Hospital (LTACH) experienced a high rate of Central Line-Associated Bloodstream Infections (CLABSI). This hospital had forty-four CLABSI's, a rate of 4.47 per 1000 central line days. Methods Direct observation by the new Infection Control Practitioner determined many central line dressings to be loose, soiled, and/or in place for longer than 7 days. Further observation confirmed staff knowledge regarding the importance of adhering to aseptic techniques and maintenance of the dressings was deficient. Intensive education of the Nursing staff was initiated in aseptic technique, how to assess the integrity of the central line dressing, weekly and as-needed dressing changes, blood culture collection, and the importance of daily chlorhexidine bathing. Staff was required to be included in the Root Cause Analysis (RCA) on every infection, and the results of each RCA were disseminated at daily Nursing Huddles. Frequent feedback to staff regarding declining rates helped provide a sense of pride and ownership. Results Our CLABSI rate dropped to 1.18 and 2.18 per 1000 central line days in 2017 and 2018, respectively, maintaining a reduction in the CLABSI rate of more than 50%. To verify the decrease, the Hospital-Acquired Infection Prevention Program Liaison from California Department of Public Health performed a validation study in 4th quarter of 2017 and found 100% accuracy in correct determination of CLABSI events, following the National Healthcare Surveillance Network definitions. Conclusions In conclusion, reiteration with emphasis on basic preventative aseptic techniques including the importance of potential infection site observation effectively and dramatically reduced the CLABSI rate at this LTACH. By routinely including the staff in the Root Cause Analysis process, they recognized the importance of these techniques and felt ownership in the results, thereby enhancing ongoing patient care. During 2016, our Long Term Acute Care Hospital (LTACH) experienced a high rate of Central Line-Associated Bloodstream Infections (CLABSI). This hospital had forty-four CLABSI's, a rate of 4.47 per 1000 central line days. Direct observation by the new Infection Control Practitioner determined many central line dressings to be loose, soiled, and/or in place for longer than 7 days. Further observation confirmed staff knowledge regarding the importance of adhering to aseptic techniques and maintenance of the dressings was deficient. Intensive education of the Nursing staff was initiated in aseptic technique, how to assess the integrity of the central line dressing, weekly and as-needed dressing changes, blood culture collection, and the importance of daily chlorhexidine bathing. Staff was required to be included in the Root Cause Analysis (RCA) on every infection, and the results of each RCA were disseminated at daily Nursing Huddles. Frequent feedback to staff regarding declining rates helped provide a sense of pride and ownership. Our CLABSI rate dropped to 1.18 and 2.18 per 1000 central line days in 2017 and 2018, respectively, maintaining a reduction in the CLABSI rate of more than 50%. To verify the decrease, the Hospital-Acquired Infection Prevention Program Liaison from California Department of Public Health performed a validation study in 4th quarter of 2017 and found 100% accuracy in correct determination of CLABSI events, following the National Healthcare Surveillance Network definitions. In conclusion, reiteration with emphasis on basic preventative aseptic techniques including the importance of potential infection site observation effectively and dramatically reduced the CLABSI rate at this LTACH. By routinely including the staff in the Root Cause Analysis process, they recognized the importance of these techniques and felt ownership in the results, thereby enhancing ongoing patient care.

Strategies to halt 2019 novel coronavirus (SARS-CoV-2) spread for organ transplantation programs at the Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, China.

During the 2019 novel coronavirus (SARS‐CoV‐2) outbreak in China (from January 24 to March 11, 2020), our center performed 16 organ transplants (10 kidney, 4 liver, and 2 lung transplants) harvested from deceased donors. Regarding the strategies to prevent infections of SARS‐CoV‐2, we implemented specific measures for the donor and recipient management, as well as prevention of hospital‐acquired infections. All 16 organ recipients had a favorable outcome without SARS‐CoV‐2 infection. Our approaches aiming to interrupt the spread of SARS‐CoV‐2 within the transplantation wards were successful, and allowed us to maintain the transplantation program for deceased liver, kidney, and lung organ recipients.

Postoperative Wound Irrigation Using Distilled Water in Preventing Surgical Site Infection in a Tertiary Hospital: A Retrospective Cohort and Cost-effective Study

Background. The incidence of surgical site infections (SSIs) is reducing following the global campaign that requires all the stakeholder involvement. However, of all hospital-acquired infection prevention programs, wound irrigation is hard to be implemented in our hospital. There is a belief that the wound irrigation procedure leading to the spreading of infection. In contrast, the use of antiseptic and topical antibiotic, as well as systemic antibiotic, is uncontrolled high. Thus, we run a cost-effective study of wound irrigation to change the practice.

Bugs Can Be Busted: How to Prevent Hospital-Acquired Infections A Success Story of Norwegian American Hospital, Chicago, U.S.A, in Substantially Reducing Hospital-acquired Infection (HAI) Rates

Hospital-acquired infections (HAIs) including Central Line -Associated Bloodstream Infections (CLABSI), CatheterAssociated Urinary Tract Infections (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA) infections, Clostridium difficle Infections (CDI), Surgical Site Infections (SSI), and Ventilator-Associated Pneumonia (VAP) are among the most common and serious patient safety threats in the health care settings, which contribute to significant morbidity, mortali-ty, length of patient stay, and healthcare cost. To combat increasing number of HAI, Norwegian American Hospital (NAH), Chicago, Illinois, USA, strategically developed, and successfully implemented a HAI control and prevention initia-tive in 2013. As a result, NAH dramatically reduced its infection rates over the next several years and the trend continues to date. Guided by Gap analysis, driven by data, gathered from both internal and external sources, and supported by hospital leadership, NAH initiated a process of gradual and transformational re-forms, by engaging, educating and empowering all clinical and administrative staff, patients, their families and community, promoting a culture of mutual responsibility, incorporating best practic-es, integrating technology into clinical practices, developing electronic standing order- sets and nurse-driven protocols, creating hand hygiene, sepsis and sexually transmitted infections task forces, and antimicrobial stewardship program, NAH successfully managed to achieve and maintain high-quality standards of patient care and lower then national benchmarks HAI rates for the last four consecutive years (January 2016 to December 2019). Among the device-associated infections (CAUTI/CLABSI), we encountered only one CAUTI and no CLABSI in 2016, none in 2017, only one CAUTI and no CLABSIs in 2018 and only one CAU-TI and one CLABSI in 2019. Furthermore, our VAP rate remained zero, we had only one SSI in 2019 and the C. Difficle Infection rates have also been steadily declining since the implementation of new preventive measures. As a result, NAH received several recognition awards from the lo-Cal as well as national health organizations.

The power is in our hands: a QI project for sustainable hand hygiene

Background Methicillin Sensitive Staphylococcus Aureus (MSSA) is a commensal associated with hospital acquired infection (HAI). MSSA HAI is associated with significant morbidity, and hand hygiene has been identified as a prominent component of HAI prevention strategies. Methods A project using Quality Improvement methodology was devised to improve rates within the surgical department: a locally identified MSSA HAI hotspot. Baseline monitoring was done using WHO checklists and departmental education presented on hand hygiene. Continued weekly auditing and feedback was carried out by the multidisciplinary team (MDT) on one ward over a four-month period, and adherence was prompted by verbal reminders and departmental education. A long-term strategy was employed for regular monitoring with a nominated member of the MDT to maintain improvements. Results Baseline audit revealed adherence of 10-52% for registrar-led rounds, and 22-62% for consultant-led, across the 5 points of hand hygiene. Particular weakness was noted before patient contact and entry to clinical areas, which was addressed with departmental education. Initial adherence after education was low (6-38%), but subsequent improvement was seen the following month (74-93%). Some of this was maintained over the final two months of data collection (50%-100%), and a PDSA cycle was employed to address this variability. As such, an MDT-wide monitoring schedule was put in place at the end of the data collection period. Conclusion This QI project sought to achieve sustainable change in adherence to hand hygiene. An MDT-wide system of monitoring and education effected this, and may prove an effective strategy in similar inpatient settings.

Prevention and Control Measures toward Hospital-Acquired Infections among Patients, Relatives, and Health Professionals in Tertiary Health-care System

Background: Nurses, as well as other health workers, have an important role to play toward preventing hospital-acquired infections (HAIs) among the patients and themselves. The most important and basic techniques in the prevention and control of infection transmission are hand washing. Objectives: The study was aimed to investigate measures utilized by health-care professionals, in the prevention and control of nosocomial infections in the selected health facility. Materials and Methods: A descriptive questionnaire was designed and used to identify and describe the measures and role of health-care professionals in the prevention and control of HAI in the Federal Medical Centre, Yenagoa. One hundred and fifteen nurses were selected at random among the health facilities to partake in the survey. Results: Respondents had good knowledge on the transmission and prevention of HAIs and that universal precaution must be employed in all aspects of patient care. All nurses strongly agreed that gloves do not transmit pathogens that cause HAIs and 88.7% of the respondents strongly disagreed that over diluted solutions are effective in decontamination as long as instruments are soaked for long periods, nurses that participated in the survey demonstrates a very good attitude towards the prevention of nosocomial infections. Some showed that personal protective equipment reduced their efficiency during procedures. Conclusion: Nosocomial infections complicate patient care and prolong the stay of patients in hospitals. The provision of safe care through the acquired knowledge and demonstration of a positive attitude will promote the preventive measures and subsequent incidence of HAIs.

Hospital infection control and behaviour of operating room staff.

Surgical site infections (SSIs) are a frequent complication of surgical procedures and one of the most common forms of hospital acquired infection (HAI). National/international guidelines and recommendations have been issued for prevention. The objective of this study was to observe the behaviour of healthcare workers engaged in surgical procedures and hence assess compliance with SSI guidelines. An observational descriptive study was conducted at a University hospital in southern Italy. A specifically designed form was used to record the actions of the surgical team during randomly selected surgical operations. Observations comprised the use of surgical attire, the frequency of doors opening and the number of staff in the operating room. A total of 308 operating room personnel was observed during 402 surgical procedures: 127 surgeons (41%), 39 anaesthesiologists (13%), 62 nurses (20%) and 80 students in training (26%). 96% of the surgical team wore scrubs, 93% of health workers wore a mask and of these 78% wore it correctly in order to completely cover the nose, mouth and beard (when present), 99% wore a cap (only in 48% was the hair completely covered), 50% of the operators wore gloves, 95% wore shoes dedicated to the operating theater and 23% also wore shoe covers, 56% wore gowns, and 22% had eye protection. Furthermore, the average number of health personnel in the operating theater was 8, the doors remained closed in 261 (65%) surgical operations. As the results indicated a low adherence to international guidelines among the personnel, it is suggested that training courses should be provided to increase staff awareness on prevention and management of HAI.

Antibacterial Effects of Peganum harmala Seed Extracts on Drug-resistant Clinical Isolates of Acinetobacter baumannii in North of Iran

Background: Acinetobacter baumannii is one of the most common and important causes of hospital-acquired infections. Due to its intrinsic resistance to antibiotics, A. baumannii can survive in the hospital environment for a long time and target hospitalized patients. Therefore, treatment and prevention of hospital-acquired infection with these bacteria require identification of new antibacterial agents with no or fewer side effects and toxicity. Objectives: The aim of this study was to investigate and compare the antibacterial effects of the aqueous and ethanolic extracts of Peganum harmala on multidrug-resistant, extensively drug-resistant and pandrug-resistant Acinetobacter baumannii isolates. Methods: Antimicrobial susceptibility of the isolates was determined using the Kirby-Bauer method according to the Clinical and Laboratory Standards Institute document M100-S25 (2015). Antimicrobial activity of the ethanolic and aqueous extracts of P. harmala against drug-resistant A. baumannii isolates was determined by the agar well diffusion method. In addition, broth microdilution susceptibility testing was carried out to determine the minimum inhibitory concentrations (MICs) of the extracts. Finally, active compounds with antimicrobial activity were identified by gas chromatography-mass spectrometry. Results: The frequencies of the multidrug-resistant, extensively drug-resistant and pandrug-resistant A. baumannii isolates were 37.2%, 58.2% and 61%, respectively. The MIC90 of the aqueous extract of P. harmala was 1024 μg/mL, which was four times less than that of its ethanolic extract (4096 μg/mL). Similarly, the MIC50 of the aqueous extract of P. harmala was significantly smaller than that of the ethanolic extract (P < 0.05). According to the results, vasicine/peganine and 8-hydroxy deoxy peganine were the most abundant (39.94%) bioactive compounds in the aqueous extract of P. harmala. Conclusions: The aqueous extract of P. harmala had excellent antimicrobial effects on the resistant A. baumannii isolates.

Health care workers knowledge, attitude and practice towards hospital acquired infection prevention at Dessie referral hospital, Northeast Ethiopia

Introduction: Contact of health care workers and patient at health facility lead to the transmission of pathogenic organisms to each other. Hospital acquired infection prevention is standardized guide lines contain multitude protocols needed to be implemented by health care workers to reduce hospital acquired infections.

1194. Gender Differences in Psychosocial Determinants of Hand Hygiene Among Doctors

BackgroundHand hygiene (HH) is essential in the prevention of hospital-acquired infections. It is known that there are differences in the compliance of HH between men and women but the reason for this phenomenon is unclear.MethodsA survey on HH was conducted in July 2018 among healthcare workers at four different referral hospitals in South Korea. The differences between male and female doctors were then analyzed. The survey included a structured questionnaire with seven parts: (1) self-assessment of HH execution rate, knowledge, attitude, and behavior regarding HH, (2) internal motivation for better HH, (3) obstacles for HH, (4) emotional motivation, (5) the need for external supervision, (6) preference for alcohol gel, and (7) embarrassment due to supervision.ResultsOf the 1046 healthcare workers that replied to the survey, 201 (19.2%) were doctors, and of these, 129 (63.5%) were men. There was no significant difference between male and female doctors on the questionnaire related to knowledge, attitude, and behavior regarding HH. On the questions regarding internal motivation for better HH, male doctors had a higher tendency to agree that “I would be better at HH if it was related to getting a promotion,” but the results were statistically insignificant (5.08 vs. 4.69, P = 0.08). For the 14 questions about the obstacles for HH, the following five categories showed significantly higher results in men: (1) HH is difficult in emergency situations (4.87 vs. 4.51, P = 0.02), (2) time that could be spent on something more important is wasted on HH (3.12 vs. 2.67, P = 0.008), (3) HH is not a habit (3.26 vs. 2.58, P = 0.002), (4) I often forget about HH situations (3.60 vs. 2.89, P = 0.002), and (5) I do not perform HH because there is no disadvantage when I do not perform it (3.06 vs. 2.42, P = 0.008). In the category “HH causes pain and dryness of hands,” female doctors had a significantly higher tendency to agree (3.62 vs. 4.32, P = 0.003). Among the questions regarding emotional motivation, women had a higher tendency to agree that “Seeing a fellow employee perform bad HH angers me,” but there was no statistical significance (3.73 vs. 4.10, P = 0.07).ConclusionThere was a significant difference between male and female doctors regarding obstacles for HH. A campaign for HH based on these results could be helpful for increasing HH compliance. Disclosures All authors: No reported disclosures.

Chlorhexidine bathing of the critically ill for the prevention of hospital-acquired infection.

Hospital-acquired infection is a frequent adverse event in patient care; it can lead to longer stays in the intensive care unit (ICU), additional medical complications, permanent disability or death. Whilst all hospital-based patients are susceptible to infections, prevalence is particularly high in the ICU, where people who are critically ill have suppressed immunity and are subject to increased invasive monitoring. People who are mechanically-ventilated are at infection risk due to tracheostomy and reintubation and use of multiple central venous catheters, where lines and tubes may act as vectors for the transmission of bacteria and may increase bloodstream infections and ventilator-associated pneumonia (VAP). Chlorhexidine is a low-cost product, widely used as a disinfectant and antiseptic, which may be used to bathe people who are critically ill with the aim of killing bacteria and reducing the spread of hospital-acquired infections. To assess the effects of chlorhexidine bathing on the number of hospital-acquired infections in people who are critically ill. In December 2018 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trial registries for ongoing and unpublished studies, and checked reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. We included randomised controlled trials (RCTs) that compared chlorhexidine bathing with soap-and-water bathing of patients in the ICU. Two review authors independently assessed study eligibility, extracted data and undertook risk of bias and GRADE assessment of the certainty of the evidence . We included eight studies in this review. Four RCTs included a total of 1537 individually randomised participants, and four cluster-randomised cross-over studies included 23 randomised ICUs with 22,935 participants. We identified one study awaiting classification, for which we were unable to assess eligibility.The studies compared bathing using 2% chlorhexidine-impregnated washcloths or dilute solutions of 4% chlorhexidine versus soap-and-water bathing or bathing with non-antimicrobial washcloths.Eight studies reported data for participants who had a hospital-acquired infection during the ICU stay. We are uncertain whether using chlorhexidine for bathing of critically ill people reduces the rate of hospital-acquired infection, because the certainty of the evidence is very low (rate difference 1.70, 95% confidence interval (CI) 0.12 to 3.29; 21,924 participants). Six studies reported mortality (in hospital, in the ICU, and at 48 hours). We cannot be sure whether using chlorhexidine for bathing of critically-ill people reduces mortality, because the certainty of the evidence is very low (odds ratio 0.87, 95% CI 0.76 to 0.99; 15,798 participants). Six studies reported length of stay in the ICU. We noted that individual studies found no evidence of a difference in length of stay; we did not conduct meta-analysis because data were skewed. It is not clear whether using chlorhexidine for bathing of critically ill people reduced length of stay in the ICU, because the certainty of the evidence is very low. Seven studies reported skin reactions as an adverse event, and five of these reported skin reactions which were thought to be attributable to the bathing solution. Data in these studies were reported inconsistently and we were unable to conduct meta-analysis; we cannot tell whether using chlorhexidine for bathing of critically ill people reduced adverse events, because the certainty of the evidence is very low.We used the GRADE approach to downgrade the certainty of the evidence of each outcome to very low. For all outcomes, we downgraded evidence because of study limitations (most studies had a high risk of performance bias, and we noted high risks of other bias in some studies). We downgraded evidence due to indirectness, because some participants in studies may have had hospital-acquired infections before recruitment. We noted that one small study had a large influence on the effect for hospital-acquired infections, and we assessed decisions made in analysis of some cluster-randomised cross-over studies on the effect for hospital-acquired infections and for mortality; we downgraded the evidence for these outcomes due to inconsistency. We also downgraded the evidence on length of stay in the ICU, because of imprecision. Data for adverse events were limited by few events and so we downgraded for imprecision. Due to the very low-certainty evidence available, it is not clear whether bathing with chlorhexidine reduces hospital-acquired infections, mortality, or length of stay in the ICU, or whether the use of chlorhexidine results in more skin reactions.

Role of Health Care Professionals in Prevention of Hospital-Acquired Infections Caused By Carbapenemase Resistant Bacteria: Proactive Approach S in General Hospital Ptuj.

Background: Health-related infections represent a very important complication of health care treatment. They are associated with high morbidity, mortality, disability and high costs of treatment, care and rehabilitation. The problem is its rising incidence, mainly as pathogens have developed various antimicrobial resistance mechanisms. Enterobacterias that excrete carbapenemases are a significant problem, especially as the treatment options for infections is increasingly limited. Several guidelines dictate measures to prevent their spread and control at different levels of health care. Implementation of guidelines in practice is not easy, as it requires a lot of knowledge, cooperation, consistency, material, environmental and human resources. The role of health care professionals is indispensable in this field. The aim of the article is to present the role of health care professionals in the prevention of Carbapenem-resistant Enterobacteriaceae (CRE) infections and proactive approach of General hospital Ptuj in preventing and controlling CRE.

Characterizing the Antimicrobial Properties of 405 nm Light and the Corning® Light-Diffusing Fiber Delivery System.

Background and ObjectivesHospital‐acquired infections (HAIs) and multidrug resistant bacteria pose a significant threat to the U.S. healthcare system. With a dearth of new antibiotic approvals, novel antimicrobial strategies are required to help solve this problem. Violet‐blue visible light (400–470 nm) has been shown to elicit strong antimicrobial effects toward many pathogens, including representatives of the ESKAPE bacterial pathogens, which have a high propensity to cause HAIs. However, phototherapeutic solutions to prevention or treating infections are currently limited by efficient and nonobtrusive light‐delivery mechanisms.Study Design/Materials and MethodsHere, we investigate the in vitro antimicrobial properties of flexible Corning® light‐diffusing fiber (LDF) toward members of the ESKAPE pathogens in a variety of growth states and in the context of biological materials. Bacteria were grown on agar surfaces, in liquid culture and on abiotic surfaces. We also explored the effects of 405 nm light within the presence of lung surfactant, human serum, and on eukaryotic cells. Pathogens tested include Enterococcus spp, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., Staphylococcus epidermidis, Streptococcus pyogenes, Candida albicans, and Escherichia coli.ResultsOverall, the LDF delivery of 405 nm violet‐blue light exerted a significant degree of microbicidal activity against a wide range of pathogens under diverse experimental conditions.ConclusionsThe results exemplify the fiber's promise as a non‐traditional approach for the prevention and/or therapeutic intervention of HAIs. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Cost-effectiveness of interventions to reduce the risk of healthcare-acquired infections in middle-income countries: A systematic review.

Hospital-acquired infections (HAI) contribute to prolonged hospital stays and account for a substantial economic burden to healthcare systems. Middle-income countries (MICs) experience a greater burden of HAI than developed countries. Evidence on the cost-effectiveness of interventions to reduce HAI is required to inform decision-making in these settings. To synthesise the evidence on cost-effectiveness as related to HAI interventions in MICs and to assess the quality of this evidence. A systematic review of published literature on the cost-effectiveness of interventions to reduce the incidence of HAI in MICs between 2000 and 2018 was conducted. Six studies met the pre-determined inclusion criteria. The studies were from three countries: Thailand; India; and Vietnam. The evidence suggests that interventions to reduce HAI are cost-effective and, in most cases, cost-saving to healthcare systems. The quality of the reporting varied across studies. The implementation of HAI prevention interventions appears to be a high value use of resources in MICs. There is a need for further cost-effectiveness analyses in a wider range of MICs in order to confirm these findings. Improved standardisation and quality of reporting is required.

Utilizing a Business Case to Link Reduction in Infections to Reduction in?Costs

BACKGROUND A review of literature indicates that expanding chlorhexidine gluconate (CHG) bathing beyond those at high risk to all patients can reduce hospital-acquired infection (HAI) rates. However, infection prevention strategies are often viewed as soft costs and difficult to fund despite HAI prevention being associated with significant cost avoidance. METHODS In February 2017 a task force was assembled to assess risk mitigation. A return on investment (ROI) was compiled for leadership highlighting the potential cost benefit of decreasing Central Line Associated Bloodstream Infections (CLABSI), Catheter Associated Urinary Tract Infections (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA) bacteremia and Clostridium Difficile HAIs by expanding CHG use. We calculated the total cost of HAIs from 2016, including Centers for Medicare and Medicaid Hospital Acquired Condition Reduction Program (CMS HACRP) penalty (fiscal year 2017) [100% attribution to HAIs], direct cost and cost impact of HAI reduction using CHG bathing in current high risk populations and projected reductions and cost savings based on literature reviews and applied to all patients house-wide. On April 4, 2017 house-wide CHG bathing for all patients was implemented. Intensive staff education was provided with both face-to-face and electronic educational sessions with reinforcement at the annual employee quality fair. Compliance was measured by routine audits (chart reviews, unit rounds and staff feedback). RESULTS House-wide CHG bathing realized a CLABSI reduction of 65%. With a $17,445 direct cost per CLABSI, our total cost impact of reduction for this HAI was $226,785. Other infection decreases attributed to CHG bathing ranged from 28%-30%, raising the cost impact of HAI reduction to $439,803. CHG bathing costs totaled $40,114.10. CONCLUSIONS Identifying and quantifying the costs and benefits attributable to reduced HAIs at the facility level allows Infection Preventionists to present a business case necessary to justify program initiatives and drive improvement.

Knowledge, Attitude and Practice of Staff nurses on Hospital Acquired Infections in tertiary care Hospital of Dhaka city

Introduction : Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient’ hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections.&#x0D; Objective : The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city.&#x0D; Methods and Materials : This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection. Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software.&#x0D; Result : Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene.&#x0D; Conclusion : The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended.&#x0D; Northern International Medical College Journal Vol.10(1) Jul 2018: 347-350

A Study on Hospital Acquired Infections among Patients in a Tertiary Care Hospital of Darjeeling District, West Bengal

Introduction&#x0D; Hospital Acquired Infections (HAI), also called ‘Nosocomial Infections’ are identified at least 48-72 hours following admission to health institution. In many hospitals, HAI appears to be a hidden, cross-cutting problem. Thus a continuous surveillance is imperative for determining the extent of the problem and its effective prevention and control. Present study determines the incidence and different types of hospital acquired infections and the bacterial pathogens responsible for those.&#x0D; Materials and Methods&#x0D; An observational longitudinal study was undertaken during January to June 2014, among 107 patients admitted in ENT wards of North Bengal Medical College and Hospital (NBMCH), selected by consecutive inclusion technique. Information was taken using a predesigned, pretested semi-structured schedule. The collected data were analyzed as frequencies, percentages and means ± standard deviations.&#x0D; Results&#x0D; The present study found incidence rate of hospital acquired infections as 19.6% and incidence density as 26.35 per 1000 patient days. Surgical site infection was commonest type (57.2%) followed by urinary tract infection (23.8%) and blood stream infection (19.0%) respectively. 15.4% of blood cultures, 100.0% of surgical wound swab cultures and 21.7% of urine cultures were positive and gram negative bacteria were most frequently occurring organisms. Most commonly found bacteria were Pseudomonas and Klebsiella.&#x0D; Discussion &#x0D; Background characteristics of the study population; incidence rate, the different types of hospital acquired infections among those admitted patients and the bacterial pathogens responsible for those infections have been discussed along with review of literature.&#x0D; Conclusion&#x0D; Even if in a tertiary health care facility, hospital acquired infection rate could not be brought down into &lt;10%. So implementation of stringent guidelines on prevention of HAI and continuous surveillance and monitoring system can help to diminish this problem in future.